Biomedical subjects
Publications and source records attributed to Y Navelet.
A clinical and electrophysiological study was carried out on 20 children in hospital during the neonatal period and who experienced convulsions on the fifth day of life. The clinical and electrophysiological course has been similar and favourable in all cases. The aetiology and long term prognosis, however, remain unknown.
The purpose of this study was to evaluate the prognostic value of neonatal E.E.G. tracings in children born at term. The clinical course of 45 children was followed and related to E.E.G. abnormalities reported during the first 5 days of life. Essentially the findings confirmed those previously reported by others. However some differences were noted: paroxysmal tracings were not associated with a poor clinical state, and moderately abnormal tracings (the prognostic significance of which has never been defined) led on sometimes to a severe encephalopathy. We wish to stress certain aspects of our findings: -recordings in the first 24 hours of life may be misleading. -recordings, to be of value, must be taken before any treatment which could induce paroxystic E.E.G. patterns. -E.E.Gs should be repeated during the post-natal period when the findings are non-specific. -the prognostic significance of tracings reported as "generalised or localised overactivity" should be evaluated.
The authors studied 11 children (mean age 5 1/2 years) before and during anaesthesia, and then several times from 1 to 6 hours after the injection of althesin. The anaesthetic agent was either pure althesin or althesin combined with dextromoramide. The electroclinical correlations described for adults are also found in children: slow waves, discontinuous and then isoelectric recording during the operation stage, then rapid recovery after ending drug administration. The special interest of this study was the analysis of E.E.G. recordings during the hours following clinical recovery: only once was the recording like that of full consciousness. Repeated recordings were all of drowsiness and even sleep, despite the clinical state of the subject. A short associated study concerns the E.E.G. of neonates during their first 24 hours, born to mothers anaesthetised with alfathesin.
Polygraphic recordings were used to study respiration and night sleep in 26 such children. These children, who were "at risk" for sudden and unexpected death, could be divided into two groups : near-miss (NM) (15 cases), and those who were brothers, sisters, or cousins of a child who had died suddenly and unexpectedly (8 cases), or had periodic respiration (RP) (3 cases). No significant differences were found between the groups in respiratory tests, except for a significantly lower RP rate in the NM group and an increase in number of isolated pauses. Sleep organization was similar in both groups, though there was a significantly higher rate of active sleep (SA) in the NM group more than 2 months old. The highest respiratory indices were noted in the extreme cases of a non-NM group (including 2 brothers of infants who had died unexpectedly). Treatment with Diphemanil methylsulfate (Prantal) reduced the number of SA and respiratory pauses of the NM infants less than 2 months old.
A comparative E.E.G. study was conducted in 40 newborns, gestational age varying from 28 to 40 weeks, who were found to have intraventricular hemorrhages at autopsy, and 21 infants of the same ages in whom intraventricular hemorrhage was absent on computed tomography examinations. Early and repeated E.E.G. examinations were carried out in both groups. Anomalies were present more frequently in the group with intraventricular hemorrhage, and in half the cases a disorganized E.E.G. was observed with a maturation impossible to evaluate. Other E.E.G. anomalies (electrical seizures, positive rolandic spikes, flat or paroxystic tracings) were more frequent in the disorganized tracings than in those where maturation was possible. The anomalies recorded appeared earlier (before the 4th day of life), and were more easily identifiable in the newborn over 50 weeks of age, positive rolandic spikes being less frequent than electrical seizures and not occurring before 30 weeks.